TY - JOUR
PY - 2023//
TI - Comparing severely injured trauma patients admitted to investor-owned versus public and not-for-profit hospitals reveals opportunities for improvement in the US
JO - American surgeon
A1 - Hernandez, Jennifer
A1 - Spector, Chelsea L.
A1 - Quintero, Luis A.
A1 - Shatawi, Zaineb
A1 - Rosenthal, Andrew
A1 - Curcio, Gary
A1 - Buicko, Jessica L.
A1 - Parreco, Joshua P.
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - BACKGROUND: Non-elderly trauma patients represent the largest portion of preventable years of life loss in the US. The purpose of this study was to compare outcomes in patients admitted to investor-owned vs public and not-for-profit hospitals across the US. MATERIAL AND METHODS: The Nationwide Readmissions Database 2018 was queried for trauma patients with an Injury Severity Score greater than 15 and age 18-65 years. The primary outcome was mortality; secondary outcomes were prolonged length of stay (LOS) greater than 30 days, readmission within 30 days, and readmission to a different hospital. Patients admitted to investor-owned hospitals were compared to public and not-for-profit hospitals. Univariable analysis was performed using chi-squared tests. Multivariable logistic regression was performed for each outcome.
RESULTS: 157 945 patients were included with 11.0% (n = 17 346) admitted to investor-owned hospitals. The overall mortality rate and prolonged LOS were similar for both groups. The overall readmission rate was 9.2% (n = 13 895), with the rate in investor-owned hospitals at 10.5% (n = 1,739, P <.001). Multivariable logistic regression revealed investor-owned hospitals had an increased risk of readmission (OR 1.2 [1.1-1.3] P <.001) and readmission to a different hospital (OR 1.3 [1.2-1.5] P <.001).
DISCUSSION: Severely injured trauma patients have similar rates of mortality and prolonged length of stay in investor-owned vs public and not-for-profit hospitals. However, patients admitted to investor-owned hospitals have an increased risk of readmission and readmission to different hospitals. Efforts to improve outcomes after trauma must consider hospital ownership and readmission to different hospitals.
Language: en
LA - en SN - 0003-1348 UR - http://dx.doi.org/10.1177/00031348231160818 ID - ref1 ER -